Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients

Burgers, P.T.P.W.; Zielinski, Stephanie M.; Mailuhu, Adinda; Heetveld, Martin J.; Verhofstad, M.H.J.; Roukema, Gert R.; Poolman, Rudolf W.; Lieshout, Esther M.M. Van

doi:10.1007/s00264-014-2447-2

Cited by 17 publications

(8 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[10][11][12] Sustaining a hip fracture increases the risk of falling and often leads to subsequent fractures, which results in high morbidity and increased mortality in these patients. 13 While highly relevant for patients, the effect of surgical approach on subsequent fall risk is unknown. It could be speculated that the PLA may lead to faster rehabilitation and better balance due to the intact gluteus musculature.…”

Section: Introductionmentioning

confidence: 99%

Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review

et al. 2020

View full text Add to dashboard Cite

Background: The posterolateral approach (PLA) and direct lateral approach (DLA) are the most commonly used approaches for inserting a hemiarthroplasty in the treatment of femoral neck fractures. A recent review concluded that the routine use of PLA should be questioned, but this conclusion itself can be questioned. The aim of this study is to provide an updated overview and critical appraisal of the available evidence, focussing on outcomes most relevant for patients. Methods: We conducted a comprehensive search of literature in the MEDLINE and EMBASE databases and Cochrane Library. Studies (till June 2018) to identify hip fracture clinical trials/comparative studies comparing alternative surgical approaches (PLA and DLA). We explored sources of heterogeneity and conducted pooled analyses when appropriate. Results: 264 potentially eligible studies were identified of which 1 RCT, 3 prospective, 3 registry data and 5 retrospective studies were included. The RCT consisted performance and attrition bias. The mean MINORS score of the prospective/register studies was 17.3 (SD 3.5) and 13.8 (SD 1.9) of the 5 retrospective studies. The GRADE score for all the outcomes was very low. Due to the high and various types of biases across the included studies, we did not pool the data. None of studies assessed the activities of daily living functionality. 6 studies reported significantly more dislocations or reoperations due to dislocation in the PLA group, 6 other studies found no differences. DLA patients were more likely to develop abductor insufficiency leading to limping and more need for walking aids. The PLA patients tended to have better quality of life, less pain and more satisfaction compared to the DLA patients. Conclusion: Based on low-quality studies, PLA may be associated with more dislocations, but patients had less walking problems and a lower tendency to abductor insufficiency compared with DLA. Further clinical trials with methodology rigor are needed to determine which approach is more effective in terms of outcomes relevant to patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Approximately 20% live in a nursing home prior to the fracture. Proximal femoral fractures result in activities of daily living (ADL) dependence and increased morbidity, strongly diminishes the patients’ (health-related) Quality of Life (QoL) and total health care costs [4–7].…”

Section: Introductionmentioning

confidence: 99%

The value of nonoperative versus operative treatment of frail institutionalized elderly patients with a proximal femoral fracture in the shade of life (FRAIL-HIP); protocol for a multicenter observational cohort study

et al. 2019

Self Cite

View full text Add to dashboard Cite

BackgroundProximal femoral fractures are strongly associated with morbidity and mortality in elderly patients. Mortality is highest among frail institutionalized elderly with both physical and cognitive comorbidities who consequently have a limited life expectancy. Evidence based guidelines on whether or not to operate on these patients in the case of a proximal femoral fracture are lacking. Practice variation occurs, and it remains unknown if nonoperative treatment would result in at least the same quality of life as operative treatment. This study aims to determine the effect of nonoperative management versus operative management of proximal femoral fractures in a selected group of frail institutionalized elderly on the quality of life, level of pain, rate of complications, time to death, satisfaction of the patient (or proxy) and the caregiver with the management strategy, and health care consumption.MethodsThis is a multicenter, observational cohort study. Frail institutionalized elderly (70 years or older with a body mass index < 18.5, a Functional Ambulation Category of 2 or lower pre-trauma, or an American Society of Anesthesiologists score of 4 or 5), who sustained a proximal femoral fracture are eligible to participate. Patients with a pathological or periprosthetic fractures and known metastatic oncological disease will be excluded. Treatment decision will be reached following a structured shared decision process. The primary outcome is quality of life (Euro-QoL; EQ-5D-5 L). Secondary outcome measures are quality of life measured with the QUALIDEM, pain level (PACSLAC), pain medication use, treatment satisfaction of patient (or proxy) and caregivers, quality of dying (QODD), time to death, and direct medical costs. A cost-utility and cost-effectiveness analysis will be done, using the EQ-5D utility score and QUALIDEM score, respectively. Non-inferiority of nonoperative treatment is assumed with a limit of 0.15 on the EQ-5D score. Data will be acquired at 7, 14, and 30 days and at 3 and 6 months after trauma.DiscussionThe results of this study will provide insight into the true value of nonoperative treatment of proximal femoral fractures in frail elderly with a limited life expectancy. The results may be used for updating (inter)national treatment guidelines.Trial registrationThe study is registered at the Netherlands Trial Register (NTR7245; date 10-06-2018).

show abstract

“…A szekunder vagy ellenoldali csípőtáji törések előfordulá-sát is több tanulmány [11][12][13][14][15] vizsgálta, amelynek értéke 2,7-9% között változik az első évnél. Hazai adatok alapján a combnyaktöréseket követő ellenoldali csípőtáji tö-rések előfordulásának kockázati tényezőiről korábbi tanulmányunkban [16] számoltunk be.…”

unclassified

Ellenoldali csípőtáji törésekkel összefüggő halálozás és kockázati tényezőinek vizsgálata

et al. 2017

View full text Add to dashboard Cite

show abstract

Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients

Cited by 17 publications

References 25 publications

Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review

Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review

The value of nonoperative versus operative treatment of frail institutionalized elderly patients with a proximal femoral fracture in the shade of life (FRAIL-HIP); protocol for a multicenter observational cohort study

Ellenoldali csípőtáji törésekkel összefüggő halálozás és kockázati tényezőinek vizsgálata

Contact Info

Product

Resources

About